Difference between revisions of "Trophoblast"
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''' | '''Trophoblast''' is part of a normal [[pregnancy]]. Trophoblasts are derived from the conceptus, i.e. '''not''' maternal. | ||
Part of the trophoblast forms '''chorionic villi'''. | |||
Tumours arising from the trophoblast are dealt with in ''[[gestational trophoblastic disease]]''. | Tumours arising from the trophoblast are dealt with in ''[[gestational trophoblastic disease]]''. | ||
=Trophoblast table= | |||
Based on Shih ''et al.'':<ref name=pmid11192071/> | Based on Shih ''et al.'':<ref name=pmid11192071/> | ||
{| class="wikitable" | {| class="wikitable" | ||
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Notes: | Notes: | ||
*Keratin is positive in all trophoblastic tissue and negative in decidual tissue.<ref name=pmid1694585/> | *Keratin is positive in all trophoblastic tissue and negative in decidual tissue.<ref name=pmid1694585/> | ||
=Chorionic villi= | |||
==Chorionic villi 101== | |||
*Maternal blood is around villi. | |||
*Fetal blood (nucleated (fetal) [[RBC]]s) in the villi. | |||
===Basic histology=== | |||
*Outer layer of villus / closer to mother : syncytiotrophoblasts. | |||
*Inner layer of villus / closer to fetus : cytotrophoblasts. | |||
==Chorionic villi 102== | |||
*Syncytiotrophoblasts (eosinophilic cytoplasm with vacuoles (contain hCG), multiple hyperchromatic nuclei). | |||
**Large + many irreg. or lobular hyperchromatic nuclei. | |||
**Eosinophilic vacuolated cytoplasm (contains hCG). | |||
**Closest to mom - covers cytotrophoblast.<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref> | |||
*Cytotrophoblasts (polygonal shape, distinct borders, clear cytoplasm, in cords, single nucleus). | |||
**Polygonal shaped cells in cords/masses. | |||
**Distinct cell borders. | |||
**Covered by syncytiobrophoblast<ref>[http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png http://upload.wikimedia.org/wikipedia/commons/4/45/Gray37.png]</ref> - closer to fetus than syncytiotrophoblasts. | |||
**Clear cytoplasm. | |||
**Single uniform nucleus. | |||
==Age of villi== | |||
===Young villi=== | |||
*Do not have [[blood vessel]]s. | |||
*No syncytial knots. | |||
===Old villi=== | |||
*Blood vessels present and at the periphery of villus - contain nucleated (fetal) RBCs. | |||
*Syncytial knots. | |||
==Villi and age - table== | ==Villi and age - table== | ||
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|} | |} | ||
==See also | =Intermediate trophoblast= | ||
===General=== | |||
*Abbreviated: ''IT''. | |||
*Thought to be the cell of origin for:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref> | |||
**[[Exaggerated placental site]] (EPS). | |||
**[[Placental site nodule]] (PSN). | |||
**[[Placental site trophoblastic tumour]] (PSTT). | |||
**[[Epithelioid trophoblastic tumour]] (ETT). | |||
===Subtypes=== | |||
Three subtypes of IT are recognized:<ref name=pmid11192071>{{cite journal |author=Shih IM, Kurman RJ |title=The pathology of intermediate trophoblastic tumors and tumor-like lesions |journal=Int. J. Gynecol. Pathol. |volume=20 |issue=1 |pages=31–47 |year=2001 |month=January |pmid=11192071 |doi= |url=}}</ref> | |||
#Implanation site IT. | |||
#Villous IT. | |||
#Chorionic-type IT. | |||
===Microscopic=== | |||
Features: | |||
*Large cells. | |||
*Eosinophilic cytoplasm. | |||
**May be multi-nucleated. | |||
Images: | |||
*[http://pathology2.jhu.edu/trophoblast/introduction.cfm IT - high mag. (jhu.edu)]. | |||
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_high_mag.jpg IT - high mag. (WC)]. | |||
*[http://commons.wikimedia.org/wiki/File:Intermediate_trophoblast_-_lmwk_-_high_mag.jpg IT - LMWK - high mag. (WC)]. | |||
====IHC==== | |||
Features:<ref name=pmid1694585>{{cite journal |author=Yeh IT, O'Connor DM, Kurman RJ |title=Intermediate trophoblast: further immunocytochemical characterization |journal=Mod. Pathol. |volume=3 |issue=3 |pages=282–7 |year=1990 |month=May |pmid=1694585 |doi= |url=}}</ref> | |||
*hPL (human placental lactogen) +ve. | |||
*beta-hCG -ve. | |||
*Keratin +ve. | |||
*EMA +ve in 2nd & 3rd trimester. | |||
*CD146 +ve.<ref>URL: [http://www.epitomics.com/diagnostics/product/5618 http://www.epitomics.com/diagnostics/product/5618]. Accessed on: 14 August 2011.</ref> | |||
Notes: | |||
*Cytotrophoblast and syncytiotrophoblast - keratin +ve.<ref name=pmid1694585/> | |||
=See also= | |||
*[[Endometrium]]. | *[[Endometrium]]. | ||
*[[Products of conception]]. | *[[Products of conception]]. | ||
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*[[Arias-Stella reaction]] - benign atypical changes associated with chorionic tissue. | *[[Arias-Stella reaction]] - benign atypical changes associated with chorionic tissue. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gynecologic pathology]] | [[Category:Gynecologic pathology]] | ||
=External links= | |||
*[http://www.med.yale.edu/obgyn/kliman/placenta/articles/AJP%20Commentary.html Uteroplacental Blood Flow: The Story of Decidualization, Menstruation and Trophoblast Invasion (yale.edu)]. | *[http://www.med.yale.edu/obgyn/kliman/placenta/articles/AJP%20Commentary.html Uteroplacental Blood Flow: The Story of Decidualization, Menstruation and Trophoblast Invasion (yale.edu)]. |